Health

Advisory

MULTISTATE OUTBREAK OF SALMONELLA TENNESSEE INFECTIONS

The Division of Public Health (DPH) is forwarding this health advisory from the Centers for Disease Control and Prevention. No outbreak

associated cases have been reported in Delaware. DPH identified one case of Salmonella tennessee during the time period in

question. However, this was a Maryland resident and investigated by Maryland Department of Health and Hygiene. The Delaware Public Health

Laboratory performs serological testing on all Salmonella isolates received. Healthcare providers should notify Delaware

Division of Public Health, Bureau of Epidemiology of any suspect Salmonella case that may be related to this outbreak by calling

1-888-295-5156.

This is an official

CDC Health Advisory

Distributed via Health Alert Network

February15, 2007,09:00 EST (09:00AM EST)

CDCHAN-00258-07-02-15-ADV-N

Multistate Outbreak of Salmonella Tennessee Infections, August 2006 – January 2007

Public health officials in multiple states, with the assistance of the Centers for Disease Control and Prevention, are investigating a

large outbreak of Salmonella Tennessee infections. As of February 14, 2007, 6PM EST, 288 persons with illness have been reported

to CDC from 39 states; Alaska ,Alabama, Arkansas, Arizona, California, Colorado, Connecticut, Georgia, Iowa, Illinois, Indiana, Kansas,

Kentucky, Massachusetts, Maryland, Maine, Michigan, Minnesota, Missouri, Mississippi, Montana, Nebraska, New Jersey, North Carolina, New

Mexico, New York, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Virginia, Vermont, Washington

Wisconsin, and West Virginia.

State public health officials continue to investigate cases of illness. Among 120 patients for whom clinical information is available, 31

(26%) were hospitalized. There have been no reports of deaths attributed to this infection. Onset dates, which are known for 140

patients, ranged from August 1, 2006 to January 21, 2007. The outbreak has been prolonged and of low intensity, with 0-2 new cases

reported daily in January nationwide. Two closely related DNA fingerprint patterns of Salmonella Tennessee isolates have been associated

with this outbreak. DNA fingerprinting is routinely done at public health laboratories in all states as part of PulseNet (the network of

public health laboratories that sub-type bacteria).

CDC is working with state and local health officials, the Food and Drug Administration (FDA), and the Department of Agriculture (USDA) to

determine the food responsible for this outbreak. Public health investigators have identified peanut butter as being consumed more often

by ill persons than well persons and as statistically linked with illness. Evaluation of additional information about the brand of peanut

butter, the consumption habits of cases, and the patterns of distribution of cases is ongoing. Health officials and the peanut butter

industry representatives are working collaboratively to learn more about production of peanut butter to determine how it may have become

contaminated.

Persons who think they may have become ill from eating peanut butter are advised to visit their health care provider and call their local

health departments.

Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually

lasts 4 to 7 days, and most persons recover without treatment. However, in some persons the diarrhea may be so severe that the patient

needs to be hospitalized. The elderly, infants and those with impaired immune systems are more likely to have a severe illness.

For more information on Salmonella infection and this outbreak, please refer to the following website: http://www.cdc.gov/ncidod/diseases/submenus/sub_salmonella.htm